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Abstract
In this article, we consider how decentralizing health spending to local governments affects health care access and quality. Based on data from forty-nine countries around the world from 1996 to 2015, we find that decentralizing health spending is inimical to timely and effective health care. We also explore the role of two specific channels through which fiscal decentralization can undermine health outcomes: externalities and foregone economies of scale. We find that decentralizing health expenditure to the local level may generate externalities to the detriment of health outcomes when it is accompanied by locally elected municipal politicians who are not subject to national parties. Our results further suggest that fiscal decentralization can improve health access and quality when approximately two-thirds or more of the people in a country live in localities with more than 300,000 inhabitants, implying that below this threshold economies of scale may be foregone.

This title explores the theoretical issues, empirical evidence and normative debates elicited by the concept of multi-level governance (MLG). Three policy areas are investigated in vindicating the usefulness of MLG as a theoretical and empirical concept, with particular reference to the UK and Germany

This paper aims to investigate the effect of increasing fiscal decentralization on the composition of public expenditures in Brazilian local governments. The research is innovative by demonstrating that the heterogeneity of expenditure scale influences on the correlation between fiscal decentralization and public expenditure composition of local governments. The sample consisted of unbalanced panel data with 5,565 municipalities for 17 years from 2000 to 2016. The analysis was accomplished by unconditional quantile regression with panel data. The main findings were: (i) fiscal decentralization affects public expenditures in Brazilian local governments, however the kind of effect depends on local expenditure scale and fiscal decentralization strategy. For example, in personnel expenditures, for the median, the coefficient was negative, and the effect was positive for the third quartile of local governments, when fiscal decentralization was measured by the tax revenue over total revenue. On the other hand, the effects were also positive for median and third quartile regarding intergovernmental transfers per capita like proxy of fiscal decentralization; (ii) the measures (proxies) of fiscal decentralization are correlated with the composition of public expenditure; (iii) in median terms, fiscal decentralization has greater effects on investment expenditures than on current and personnel expenditures; and (iv) in median terms, the tax revenue participation promotes an increase in administrative and planning expenditures instead of expenditures in social functions. On the other hand, fiscal decentralization measured by intergovernmental transfer per capita has more positive effects on social functions than on legislative and administrative functions.

The article analyzes the main promising areas of digitalization of local self-government in the context of management science. It is proved that such areas are: opening public information about the activities of local selfgovernment; introduction of e-democracy technologies; digitalization of management processes in local self-government; digitalization of public services by local self-government; introduction of smart technologies into community infrastructure at various levels. The choice of priority depends on the needs and priorities of a particular community and local self-government. As the scope of digitalization widens across society at large, multilevel governance arrangements have become more complex and more consequential to the coherence, performance, and accountability. While this assertion has arguably been true for quite some time, the emergence of Covid-19 has magnified its importance. At the moment, Ukraine already has positive examples of the use of «digital» technologies. The advantages that municipal structures receive from the introduction of digital technologies in their work have been shown. The results show that there is a relationship between the degree of digitalization in a municipality and the perceived satisfaction among its citizens. The findings show that outdated laws and the culture of paper document flows were institutional barriers to the digitalization. Other barriers included non-use of an integrated system implementation approach as well as inadequate and unreliable online access for all the participating units.

Partial contents: Political parties and decentralization; Effective management as a precondition of effective decentralization; Administrative decentralization and neighborhood government: the New York City experience; The great revenue sharing debate.

In the past several decades, many countries, among them non-democratic, chose to decentralize their governments. Building on insights provided by the "second generation" wave of research on fiscal federalism, this paper proposes a unified model to account for this. The idea is that decentralization serves as a commitment device to ensure that ex post chose policies will reflect regional preferences, thereby boosting individual productive effort incentives. This theory may explain the decentralization process in China in 1980-1990s, as well as the fact that government decentralization is generally more prevalent in democracies.